Examples
benzodiazepines, barbiturates, gamma hydroxybutyrate (GHB)
Routes of Use
typically ingestion
Observed Symptoms
Adults: Sedation, slurred speech, ataxia, nystagmus (shaking eyes)
Prenatal Exposure
Prenatal exposure to benzodiazepines may lead a newborn to experience withdrawal symptoms known as neonatal abstinence syndrome. Symptoms of withdrawal include: feeding difficulties, diaper rash, excessive suck, difficulty sleeping, irritability, muscle tightness or tremors, increased temperature, fast breathing. NAS occurs within a week of birth, usually within 48 hours and symptoms may last weeks to months. Exposure to benzodiazepines in utero has concerns for facial clefts, cardiac malformations, but no syndrome has been identified.
Breastfeeding
The amount that enters the breastmilk will vary depending on the specific drug. Prescribed medications may be considered safe, consult a physician to clarify unique circumstances.
benzodiazepines, barbiturates, gamma hydroxybutyrate (GHB)
Routes of Use
typically ingestion
Observed Symptoms
Adults: Sedation, slurred speech, ataxia, nystagmus (shaking eyes)
- Withdrawal: similar to alcohol: irritability, anxiety, tremor, sleep disturbance nausea, seizures and psychosis.
- Child: same, respiratory depression
Prenatal Exposure
Prenatal exposure to benzodiazepines may lead a newborn to experience withdrawal symptoms known as neonatal abstinence syndrome. Symptoms of withdrawal include: feeding difficulties, diaper rash, excessive suck, difficulty sleeping, irritability, muscle tightness or tremors, increased temperature, fast breathing. NAS occurs within a week of birth, usually within 48 hours and symptoms may last weeks to months. Exposure to benzodiazepines in utero has concerns for facial clefts, cardiac malformations, but no syndrome has been identified.
Breastfeeding
The amount that enters the breastmilk will vary depending on the specific drug. Prescribed medications may be considered safe, consult a physician to clarify unique circumstances.
If we know that a caregiver is using Benzodiazepines, for example, one of the possible withdrawal symptoms is seizures and/or psychosis. This is important to know in planning when a caregiver should or shouldn’t be alone with or even around a child. This can be helpful in asking caregivers and support systems what they see and what they’re worried about.
Urine
Many of the commonly used benzodiazepines (lorazepam, alprazolam, midazolam) may not return a positive benzodiazepine screen. If the result is unexpected (whether positive or negative), or evaluating for specific benzodiazepine use is needed, a confirmatory test is recommended. Most benzodiazepines and barbiturates are positive for a 1-3 days after acute use, some up several weeks depending on chronicity of use.
Blood
There are blood tests available to measure concentrations of various sedatives / hypnotics at most reference laboratories. However, clinical examination / observation and confirmatory urine are usually sufficient. Concentrations can be difficult to correlate with intoxication depending on the tolerance of the user.
Meconium
Assays for several benzodiazepines and barbiturates can be tested to evaluate for maternal use.
Umbilical Cord
Assays for several benzodiazepines and barbiturates can be tested to evaluate for maternal use.
Hair
Assays for several benzodiazepines and barbiturates can be tested to evaluate for exposure.
Many of the commonly used benzodiazepines (lorazepam, alprazolam, midazolam) may not return a positive benzodiazepine screen. If the result is unexpected (whether positive or negative), or evaluating for specific benzodiazepine use is needed, a confirmatory test is recommended. Most benzodiazepines and barbiturates are positive for a 1-3 days after acute use, some up several weeks depending on chronicity of use.
Blood
There are blood tests available to measure concentrations of various sedatives / hypnotics at most reference laboratories. However, clinical examination / observation and confirmatory urine are usually sufficient. Concentrations can be difficult to correlate with intoxication depending on the tolerance of the user.
Meconium
Assays for several benzodiazepines and barbiturates can be tested to evaluate for maternal use.
Umbilical Cord
Assays for several benzodiazepines and barbiturates can be tested to evaluate for maternal use.
Hair
Assays for several benzodiazepines and barbiturates can be tested to evaluate for exposure.
